HomeMy WebLinkAboutContract 51046-CA451046-CA1
CITY OF FORT WORTH
ASSIGNMENT
For value received PDQ Staffing, Inc. ("Assignor"), hereby assigns to AD -A -Staff, Inc.
("Assignee"), all of its right, title, and interest in and to any and all sums of money now due or to
become due from the City of Fort Worth to Assignor under CSCO 54106 (the "Contracts") and
Assignee agrees to assume and perform all duties and obligations required by Assignor under the
terms of the Contracts.
This Assignment constitutes the entire agreement between Assignor and Assignee with
respect to the subject matter hereof. No modification of any provision of this Assignment shall
be effective unless in writing and signed by Assignor and Assignee. This Assignment shall inure
to the benefit of and be binding upon Assignor and Assignee and their respective successors and
assigns. This Assignment shall be governed by the terms of the original Contracts between
Assignor and various other entities and the City of Fort Worth and the laws of the State of Texas,
without application of principles of conflicts of law.
This Assignment may be executed in one or more counterparts each of which shall be
deemed an original but all of which together shall constitute one and the same instrument.
Signed signature pages may be transmitted by facsimile or e-mail, and any such signature shall
have the same legal effect as an original.
Dated the day of Je_�o
2024.
PDQ Staffing, Inc.
(Assignor)
By:
Print:
Title: Chief Operating Officer
AD -A -Staff, Inc.
(Assignee}
By:
Print:
Title: Vice President
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page i of 3
NOTARY ACKNOWLEDGEMENT
On the &7+h day of rO ^P•�'f't,�J �� 2024, personally appeared
Dow E' Q-Kn Vet e , who acknowledged tome that (s)he is the Chief Operating Officer of PDQ
Staff�g, Inc. ("Assignor"), and that (s)he executed this document for the purposes and
consideration contained herein.
PDQ Staffing,
By: a"''"y''r✓
Print:
Title; Chief Operating Officer
SUBSCRIBED TO before me on this o-'e'�kday of.k4wt 2024.
[tiMA M. �CNOA
o �, Notar Public
* # STATE �F TEXAS
� ? Notary LD-125�4�29311 otary Public in and for the Stat of
"�oK , My Comm. Exp. seo. 9 2 25 ,
My commission Expires; �' _
NOTARY ACKNOWLEDGEMENT
On the day of 944VII `E 2024, personally appeared
who acknowlddged to me that (s)he is the Chief Financial Officer of
AD -A -Staff, Inc. ("Assignee"), and that (s)he executed this document for the purposes and
consideration contained herein.
AD -A -Staff, Inc.
By:
Print:
Title: €fir W CP_.-
SUBSCRIBED TO before me on this Ada of��wv.tb�, 2024.
QaY [RiNA M, OCr�OA .
Nota►y Public
STATE o�x as ar ublic in and fort e St e of
My Comm. iE p, SOP• 9. 2025 Y p
M commission Ex ires: � ®QQol
Assignment Page 2 of 3
CONSENT TO ASSIGNMENT
The City of Fort Worth consents to the assignment of PDQ Staffing, Inc. ("Assignor") to
AD -A -Staff, Inc. ("Assignee"), of all its rights, title, and obligation owing and all funds due or to
become due to Assignor under CSCO 54106 as long as all terms required of Assignor in said
contracts are met by Assignee.
CITY OF FORT WORTH
ch;-ft�D,f hel- tAw(e;-
Christopher Harder (Oct 8, 2024 08:03 CDT)
Department Director
William Johnson (Olt 8, 202414:12 CDT)
Assistant Citv Manager
ATTESTED BY:
Jannette Goodall, City Secretary
APPROVED AS TO FORM AND LEGALITY:
x�
City of fort Worth Assistant City Attorney
Contract Compliance Manager:
Oct 8, 2024
Date
Oct 8, 2024
Date
Oct 8, 2024
Date
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including ensuring all performance and
reporting requirements.
W11Mz1,11 a Oct 4 2024
Homero Beltran (Oct 4, 202407:27 CDT) 7
Employee Signature/Date
Water Systems Superintendent
Title
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 3 of 3
r.4
ADASTAFF
FXCEPTIONAI PLACEMENT SERVICES
STAFFING SPECIALISTS SINCE 1993
702 Hunters Row Ct.
Mansfield, TX 76063
817.477.1049 phone
817.225.0205 fax
September 18, 2024
2600 Lessner Rd., Suite 204
Houston, TX 77063
346.327.9100 phone
346.327.9104 fax
Re: Consent of Assignment from PDQ Staffing Inc. to Ad -A -Staff Inc. — Contract No.
CSC #564106
To Whom It May Concern:
This letter is to inform you that PDQ Staffing Inc. has been acquired by Ascend Staffing.
Therefore, Ad -A -Staff Inc. will be assuming the contractual responsibility of this
contract.
Enclosed is also our W-9.
Sincerely,
Sue Beets, CSP, SC
Vice President of Operations
817.469.6234 ext. 7501
Email: sbects@adastalf.com
E
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You Expect the Best, You Deserve Nothiniz Less!
Form W'9 Request for Taxpayer Give form to the
(Rev. March 2024) Identification Number and Certification requester. no not
Department the Treasury Go to www.irs.gov/FormW9 for instructions and the latest information. send to the IRS.
Internal
al Revenue
ue Service
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/Individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name online 1, and enter the business/disregarded
entity's name on line 2.)
Ad -A -Staff, Inc.
2 Business nameldisregarded entity name, if different from above.
`6 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check 4 Exemptions (codes apply only to
only one of the following seven boxes, certain entities, not individuals;
a see instructions on page 3):
o ❑ Individual/sole proprietor ❑ C corporation ❑✓ S corporation ❑ Partnership ElTrust/estate
H ❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) Exempt payee code (if any)
Gi C
a .� Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C. S, or P) for the tax
0 classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax
`o box for the tax classification of its owner. Compliance Act (FATCA) reporting
u ❑Other (see instructions) code (if any)
a U
w 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
ned
y and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check (Appliesuti. e he Unitedounts States.)
this box if you have any foreign partners, owners, or beneficiaries. See instructions . . . , , , . ❑ outside the United States.)
w 5 Address (number, street, and apt. or suite no.). See instructions. Requester's name and address (optional)
u�
702 Hunters Row Ct. City of Fort Worth
6 City, state, and ZIP code 100 Fort Worth Trail
Mansfield, TX 76063 Fort Worth, Texas 76102
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid 5o01al security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or
TIN, later.
Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and l
Number To Give the Requester for guidelines on whose number to enter. 1 1 5 - 2 5 1 5 3 2 3
JIM Certification _
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends a are not require to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later.
Sign Signature of - /
Here U.S. person Date
General Instructions New line 3b has been added to this form. A flow -through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise foreign partners, owners, or beneficiaries when it provides the Form W-9
noted. to another flow -through entity in which it has an ownership interest. This
Future developments, For the latest information about developments change is intended to provide a flow -through entity with information
related to Form W-9 and its instructions, such as legislation enacted regarding the status of its indirect foreign partners, owners, or
after they were published, go to www.rrs.gov1Form1N9. beneficiaries, so that it can satisfy any applicable reporting
requirements. For example, a partnership that has any indirect foreign
What's New partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC" box and enter its appropriate tax classification.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231x Form W-9 (Rev. 3-2024)
UCC Business Organizations Trademarks Notary Account HelplFeles Briefcase Loocul
Filing Number: 129203000
Original Date of Filing: November 23, 1993
Formation Date: NIA
Tax ID: 17625153239
Duration: Perpetual
Name: AD -A -STAFF, INC.
Address: 702 HUNTERS ROW CT
MANSFIELD, TX 75063 USA
Entity Type: Domestic For -Profit Corporation
Entity Status: In existence
FEIN:
BUSINESS ORGANIZAT]ONS INQUIRY - VIEW ENTITY
REGASTERED
FILING HISTORY
MANAGEiu AT
ASSUMED NAMES � AS5OCIA-Er•ENTITIES
INITLM-ADD1l
Image Document Nunlileir
Flinn Type
Filing Rau
Effective Date
Eff. Card
Pape C
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Adinles Of I -corporation
November 23. 1r>93
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June 19. 199a
June 13, 1999
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December 31.20U2
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December 31, 2004
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December 31. 2005
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